lessthanhalf said:
eidos said:
lessthanhalf said:
I'll back up what was said: the research doesn't really back the idea that moving from tirz to reta does a better job of protecting muscle.
What actually matters is resistance training of some sort, plus eating more protein. My own figure would be 1.5g/kg of body weight, though the poster above puts it at 1.2, and either one works.
Losing muscle while shedding weight isn't ideal, but in real-world terms it's basically a non-issue, unless you're already starting out with very little muscle mass. Most people who are overweight or obese are carrying extra muscle, partly because overnutrition puts them in an anabolic state and partly because hauling a heavier body demands it. So when weight comes off with GLP's, dropping some muscle along with the fat has been shown to clearly improve day-to-day physical performance, since a lighter body needs less muscle to move. During my own weight loss from 115kg down to 75 kg, it was completely obvious to me climbing a hill that each 10 kilos I shed made an enormous difference to how much effort that hill took, even though I lost some muscle along the way.
In that paper, it was a minimum.
One more thing I consider crucial: how much protein you take in. Because Tirz and Reta slow gastric emptying, you can run into a range of issues, everything from burps that smell awful to downing too much protein in a single sitting.
What matters here is that the ceiling for most people is 30g-35g of net protein in one meal — that's the most that can be digested at once. Very heavy or very muscular people might manage a bit more. Anything past that point leaves amino acids the body can't turn into protein, and those get processed into ammonia and then urea, or turned into glucose or lipids (it depends on the amino acid), or into ketone bodies. That's usually not a desirable outcome. Liver enzymes can climb, which signals metabolic stress. In some cases it progresses to chronic kidney disease and lifelong dialysis (I saw this happen to a couple of guys at my gym in the ‘80s, though they were on testosterone too, which certainly didn't help).
lessthanhalf said:
I'll back up what was said: the research doesn't really back the idea that moving from tirz to reta does a better job of protecting muscle.
What actually matters is resistance training of some sort, plus eating more protein. My own figure would be 1.5g/kg of body weight, though the poster above puts it at 1.2, and either one works.
Losing muscle while shedding weight isn't ideal, but in real-world terms it's basically a non-issue, unless you're already starting out with very little muscle mass. Most people who are overweight or obese are carrying extra muscle, partly because overnutrition puts them in an anabolic state and partly because hauling a heavier body demands it. So when weight comes off with GLP's, dropping some muscle along with the fat has been shown to clearly improve day-to-day physical performance, since a lighter body needs less muscle to move. During my own weight loss from 115kg down to 75 kg, it was completely obvious to me climbing a hill that each 10 kilos I shed made an enormous difference to how much effort that hill took, even though I lost some muscle along the way.
The year I hit 40, I put on 40 kilograms. Some people fretted over it; others tried to load me with guilt.
My response to them: at 25, walking 40 kilometers with a 40-kilogram backpack was nothing for me. The catch is that in those days I could put the backpack down in the morning and take a break.
You're right — putting weight on and then taking it off is a real journey. Each small win matters and genuinely fuels you. At the moment, checking the projected HbA1c in my CGM app gives me a real lift. I'm actually looking forward to my next blood test.
How much protein someone should eat is a fascinating topic, especially for me since protein has made up 40-50% of my calories for almost 4 years now. I struggle to find much solid long-term research on very high protein consumption. Generally, in animal studies, eating less protein (while still getting enough) is tied to living longer, yet human data hints that going higher may guard against sarcopenia, curb muscle loss during weight loss, and aid weight loss by suppressing appetite. Actually reaching protein poisoning is almost unattainable; it would demand an incredibly low intake of fat or carbs. Meanwhile, low protein diets slow the worsening of renal failure.
For roughly 30 years I have dealt with obesity related proteinuria, which almost disappears when I shed weight, and thankfully there is no real sign of progressive kidney damage, but I did worry a bit about how such an extreme protein intake might affect renal function. In my own case, at least, the proteinuria got dramatically better as I went from 145kg down to 75 kg, so there is no indication of renal harm from it, even with the very high protein consumption.
Also, a very high protein intake genuinely helps keep hunger in check. Back in 2022 when I began losing weight, I thought GLP's were impossibly expensive, so I had to do it without them, and my diet was basically low calorific density, low fat, and high protein, with zero highly rewarding / high calorie / high glycemic index carb foods, to try to avoid binge eating responses to those types of food. Luckily I can now get cheap chinese GLPs that assist with hunger, but I have kept up the very high protein intake because of how it controls appetite; with a serious lifelong obesity problem, I am unwilling to give up any edge in managing it.
